{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:16:11Z","timestamp":1791436571325,"version":"4.3.3"},"reference-count":32,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Medicine and Health Sciences at Link\u00f6ping University, County Council of \u00d6sterg\u00f6tland and Link\u00f6ping University Hospital;","award":["LIO-799111"],"award-info":[{"award-number":["LIO-799111"]}]},{"name":"Faculty of Medicine and Health Sciences at Link\u00f6ping University, County Council of \u00d6sterg\u00f6tland and Link\u00f6ping University Hospital;","award":["LIO-940688"],"award-info":[{"award-number":["LIO-940688"]}]},{"name":"Faculty of Medicine and Health Sciences at Link\u00f6ping University, County Council of \u00d6sterg\u00f6tland and Link\u00f6ping University Hospital;","award":["LIO-941169"],"award-info":[{"award-number":["LIO-941169"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Optic neuritis (ON) is an inflammatory condition of the optic nerve. ON is associated with development of demyelinating diseases of the central nervous system (CNS). CNS lesions visualized by magnetic resonance imaging (MRI) and the finding of oligoclonal IgG bands (OB) in the cerebrospinal fluid (CSF) are used to stratify the risk of MS after a \u201cfirst\u201d episode of ON. However, the diagnosis of ON in absence of typical clinical manifestations can be challenging. Methods and Materials: Here we present three cases with changes in the optic nerve and ganglion cell layer in the retina over the disease course. (1) A 34-year-old female with a history of migraine and hypertension had suspect amaurosis fugax (transient vision loss) in the right eye. This patient developed MS four years later. Optical coherence tomography (OCT) showed dynamic changes of the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) over time. (2) A 29-year-old male with spastic hemiparesis and lesions in the spinal cord and brainstem. Six years later he showed bilateral subclinical ON identified using OCT, visual evoked potentials (VEP) and MRI. The patient fulfilled diagnosis criteria of seronegative neuromyelitis optica (NMO). (3) A 23-year-old female with overweight and headache had bilateral optic disc swelling. With OCT and lumbar puncture, idiopathic intracranial hypertension (IIH) was excluded. Further investigation showed positive antibody for myelin oligodendrocyte glycoprotein (MOG). Conclusions: These three cases illustrate the importance of using OCT to facilitate quick, objective and accurate diagnosis of atypical or subclinical ON, and thus proper therapy.<\/jats:p>","DOI":"10.3390\/jcm12041309","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T02:56:08Z","timestamp":1675738568000},"page":"1309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4192-079X","authenticated-orcid":false,"given":"Yumin","family":"Huang-Link","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510275, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Division of Neurophysiology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8268-2118","authenticated-orcid":false,"given":"Helena","family":"Gauffin","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-470X","authenticated-orcid":false,"given":"Anne-Marie","family":"Landtblom","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 581 85 Link\u00f6ping, Sweden"},{"name":"Division of Neurology, Department of Medical Sciences, Uppsala University, 752 36 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4119-445X","authenticated-orcid":false,"given":"Pierfrancesco","family":"Mirabelli","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2775","DOI":"10.1093\/brain\/awz221","article-title":"Patterns of retrograde axonal degeneration in the visual system","volume":"142","author":"Baaijen","year":"2019","journal-title":"Brain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/B978-0-444-52903-9.00007-8","article-title":"Anatomy and physiology of the afferent visual system","volume":"102","author":"Prasad","year":"2012","journal-title":"Handb. Clin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/S1474-4422(17)30278-8","article-title":"Retinal layer segmentation in multiple sclerosis: A systematic review and meta-analysis","volume":"16","author":"Petzold","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.survophthal.2019.08.001","article-title":"Optic neuritis in the era of biomarkers","volume":"65","author":"Chen","year":"2020","journal-title":"Surv. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1136\/jnnp-2021-327412","article-title":"Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders","volume":"93","author":"Lu","year":"2022","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1177\/1352458514567216","article-title":"Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography","volume":"21","author":"Bennett","year":"2015","journal-title":"Mult. Scler. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s11910-015-0598-1","article-title":"Atypical Optic Neuritis","volume":"15","author":"Gaier","year":"2015","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jocn.2018.11.011","article-title":"Color vision testing versus pattern visual evoked potentials and optical coherence tomography parameters in subclinical optic nerve involvement in multiple sclerosis","volume":"61","author":"Yuksel","year":"2019","journal-title":"J. Clin. Neurosci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1016\/j.lpm.2015.03.002","article-title":"Update on clinically isolated syndrome","volume":"44","author":"Thouvenot","year":"2015","journal-title":"Press Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1212\/WNL.26.6_Part_2.26","article-title":"Distribution of plaques in seventy autopsy cases of multiple sclerosis in the United States","volume":"26","author":"Ikuta","year":"1976","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2468","DOI":"10.1212\/WNL.0000000000009504","article-title":"Asymptomatic optic nerve lesions An underestimated cause of silent retinal atrophy in MS","volume":"94","author":"Davion","year":"2020","journal-title":"Neurology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/S1474-4422(22)00200-9","article-title":"Diagnosis and classification of optic neuritis","volume":"21","author":"Petzold","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/ane.13004","article-title":"Optical coherence tomography in acute optic neuritis: A population-based study","volume":"138","author":"Soelberg","year":"2018","journal-title":"Acta Neurol. Scand."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1002\/acn3.51473","article-title":"Optical coherence tomography in multiple sclerosis: A 3-year prospective multicenter study","volume":"8","author":"Paul","year":"2021","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1212\/WNL.0000000000006583","article-title":"Misdiagnosis of multiple sclerosis","volume":"92","author":"Solomon","year":"2019","journal-title":"Neurology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/WCO.0000000000000694","article-title":"Neuromyelitis optica spectrum disorders: Still evolving and broadening","volume":"32","author":"Fujihara","year":"2019","journal-title":"Curr. Opin. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1212\/WNL.0000000000001729","article-title":"International consensus diagnostic criteria for neuromyelitis optica spectrum disorders","volume":"85","author":"Wingerchuk","year":"2015","journal-title":"Neurology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e626","DOI":"10.1212\/NXI.0000000000000626","article-title":"Classifying the antibody-negative NMO syndromes","volume":"6","author":"Yeo","year":"2019","journal-title":"Neurol.-Neuroimmunol. Neuroinflamm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1212\/WNL.0000000000000101","article-title":"Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders","volume":"82","author":"Sato","year":"2014","journal-title":"Neurology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S1474-4422(13)70259-X","article-title":"Optic neuritis","volume":"13","author":"Toosy","year":"2014","journal-title":"Lancet Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1177\/1352458514568827","article-title":"Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study","volume":"21","author":"Kuhle","year":"2015","journal-title":"Mult. Scler. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1002\/ana.25462","article-title":"Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study","volume":"85","author":"Liu","year":"2019","journal-title":"Ann. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/s10072-014-1982-3","article-title":"Acute optic neuritis: Retinal ganglion cell loss precedes retinal nerve fiber thinning","volume":"36","author":"Lindehammar","year":"2015","journal-title":"Neurol. Sci."},{"key":"ref_25","first-page":"538","article-title":"Optical Coherence Tomography versus Visual Evoked Potentials in detecting subclinical visual impairment in multiple sclerosis","volume":"7","author":"Grecescu","year":"2014","journal-title":"J. Med. Life"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s10633-017-9589-7","article-title":"VEP and PERG in patients with multiple sclerosis, with and without a history of optic neuritis","volume":"134","author":"Benedek","year":"2017","journal-title":"Doc. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1177\/1352458517707265","article-title":"A new role for evoked potentials in MS? Repurposing evoked potentials as biomarkers for clinical trials in MS","volume":"23","author":"Hardmeier","year":"2017","journal-title":"Mult. Scler. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1212\/WNL.0b013e3182a55f17","article-title":"Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children","volume":"81","author":"Friedman","year":"2013","journal-title":"Neurology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1111\/head.13153","article-title":"Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial","volume":"57","author":"Friedman","year":"2017","journal-title":"Headache"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.neurol.2018.01.378","article-title":"Myelin oligodendrocyte glycoprotein antibodies in neuromyelitis optica spectrum disorder","volume":"174","author":"Ungureanu","year":"2018","journal-title":"Rev. Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1007\/s00415-017-8532-x","article-title":"Optical coherence tomography for the diagnosis and monitoring of idiopathic intracranial hypertension","volume":"264","author":"Albrecht","year":"2017","journal-title":"J. Neurol."},{"key":"ref_32","first-page":"808-e57","article-title":"Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema","volume":"26","author":"Eleftheriou","year":"2019","journal-title":"Eur. J. Neurol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/4\/1309\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:26:18Z","timestamp":1760120778000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/4\/1309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,7]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12041309"],"URL":"https:\/\/doi.org\/10.3390\/jcm12041309","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,7]]}}}